Archive for the ‘Healthcare Informatics Resources’ Category

Informatics: Where in the World is Google Health

October 18, 2011

As a nursing instructor it amazes me how many students reference Google as a source for information. Students today are computer savvy. They can find anything they want on the computer. What I stress to them is the reliability of their source. At our school we have a list of approved websites that students can go to for research. You have mentioned emedicine and NIH as options. Students need to become familiar with websites that use evidenced based practice and that will help them with literature review. Some of those sites include: CINAHL, MEDLINE, Medscape, and National Library of Medicine. I find that if the students begin to familiarize themselves with these sites, then the skies the limit for their research. I want students to teach their patients everyday at clinical and being able to back their teaching with evidenced-based practice is the way to go.

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President Obama will not release public pictures of the dead Osama bin Laden, comment

May 17, 2011

The speed and outer boundries of healthcare informatics resources used in the case of Osama bin Laden has to be mind blowing!

I imagine that the USA armed service personnel had pictures and documentation stored on electronic devices to identify Osama bin Laden on the spot. These items had to include markings, scars, and maybe birthmarks. The same things we identify patients by in the hospital and other settings.

There also may have been a small portable lab setup present to quickly identify blood type. This does not identify a specific person. But it allows the personnel to quickly keep searching if the wrong blood type is shown. Again, this blood typing is used in the USA for quick close identification.

Telemedicine had to be in place also. It may or may not have been used during the raid. If the armed service personnel needed an answer or needed to send data, then Telemedicine or some form of it had to be quickly accessible.

I will let other healthcare informatics professionals discuss the aspect of rapid DNA analysis.

Original Post
May 11, 2011
President Obama will not release public pictures of the dead Osama bin Laden, comment
I wished I were part of the team that performed an autopsy on Osama bin Laden. There were more than the usual number of personnel for a single autopsy and/or there were several shortcuts to accomplish such an autopsy in a very short time. An autopsy will continue weeks, months, and sometimes years after a person is dissected and buried. Looking at television videos, I will guess that Osama bin Laden may have arthritis. This will show up in the forensic investigation of his death especially if it is chronic.

Original Post
May 5, 2011
President Obama will not release public pictures of the dead Osama bin Laden
Is President Barack Obama correct on this decision not to release disfigured photos of the dead Osama Bin Laden? Yes, he is.

The spirit of international and US laws prohibit the public release of photos of the deceased. Note that the US is unhappy when pictures of dead Americans are broadcasted publicly.

Morally speaking, most Americans would not want pictures of their disfigured passed away loved one broadcasted publicly. The moral, social and spiritual beliefs of a victim and family members should be taken into account. Also the moral, social, and spiritual belief of the country in possession of the pictures should be taken into account.

Ethically speaking, members of the Forensic Medical and Nursing profession are not permitted to show public pictures of the deceased. This brings me to another point. Forensic physicians, nurses, and personnel should be involved with the handling of Osama bin Laden and others. Forensic healthcare personnel are trained to be objective. They will confirm the cause of death, the time of death, the identification, and identify extra factors. The forensic healthcare personnel are removed from political and military biases. Their training includes caring for victims of war on both sides and innocent bystanders.

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Physical therapy in the ICU

August 16, 2010

Working in the ICU many of our patients are on bedrest for an average minimum of 2 days, with many as long as weeks and months. As a critical care RN, my main focus is keeping the patient hemodynamically stable and thus the musculoskeletal system takes a back seat. However, eventually once the patient is more stable, physical reconditioning takes place. When is the right time?

I think the answer is as soon as possible! I read a research study that stated one day of muscle atrophy from bedrest can take a week of physical therapy to regain. This statistic shocked me and as a result I have tried to be more cognizant of the need for physical therapy for my patients. As an advocate for my patients I try to discuss the need for physical therapy during interdisciplinary rounds as early as possible. Also, when the physical therapist is working with patients I listen so I can learn ROM exercises that I can help them perform. For our chronically ill patients that have been on bedrest for weeks or months, I attempt to do simple exercises with them such as resistance or stretching as they can tolerate. However, there are times when I simply do not have time to consistently work with them, and the physical therapists are usually stretched thin and can only visit once a day. With this said, how can the void be filled?

I feel that family is the best option. As nurses and physical therapists we need to include the family in learning and teaching exercises. Research shows that families cope better when they are involved in their loved one’s care. They are at the bedside often times most of the day and it has been my experience that they are more than happy to assist in patient care.  Involving the family early in bedside care can also help with the transition home.

I would be interested to hear what others think and what interventions they implement to help their patients recondition. I also want to know what healthcare informatics resources are available for the nurses and the families.

Computer-based Patient-education Program

April 12, 2010

Given the enormous financial strains on the health care system, and the time constraints of health care providers institutions are seeking to find innovative and cost effective ways of reducing tasks like patient education.  Leading health care centers, many dealing with cancer patients such as Memorial Sloan-Kettering Cancer Center, have taken the first steps by using computer-based learning tools.  They have documented initial success in implementing an extensive computer-based education program. Their program consists of a CD-ROM education program, an internal interactive intranet site that contains education about cancer, has library resources, and Internet links, etc. for patients to access. 

The advantages are significant and health institutions everywhere are becoming involved with alternate methods of providing and reinforcing patient education.  Obvious advantages include the quality and consistency of the information provided to the patient, the ability to access education and information independently; provide training in the language of the patient, as well cost savings to the institution.  Disadvantages are the readiness and literacy of the learner, and the inability to interact with the patient at the time questions arise. Some would argue that the disadvantages are fewer than we currently experience, given the lack of caregiver time and consistency and quality of information imparted.

There is no doubt that we will continue to move forward with computer assisted patient education in much the same way as we have with our staff development and training.  Our institution is small compared to the major centers utilizing this resource for patient education.  However, we too, have embraced the practice of CD-ROM and computer based education at our Cancer Center.  Though manned by staff trained to educate patients, we have a resource center with CD’s, interactive patient education videos and an entire resource library for the patients to access.  The union of technology and patient education is upon us and, for the most part, appears to be a win-win situation.  Our challenge, moving forward, will be to find ways to reach and capture all patients, regardless of their status.

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Health care Informatics: data, information, knowledge, and wisdom

January 29, 2010

Health care informatics, as defined by Englebardt and Nelson, 2002, is the study of how health care data, information, knowledge, and wisdom are collected, stored, processed, communicated, and used to support the process of health care delivery to clients, providers, administrators, and organizations involved in health care delivery. There are many variations of this definition, all with ultimately the same meaning. The statement that effectively explains the importance of this field is by Hannah, Ball, and Edwards, 1999, that stated, health care informatics, is truly interdisciplinary. In its truest form it focuses on the care of the patient, not a specific discipline. Therefore, even though there are specific bodies of knowledge for each health care profession, they all interface at the patient. The increasing awareness health care organizations are developing towards the informatics discipline is proving its value. I realize it is an evolving discipline and will continue to progress and grow in correlation with technology and the electronic medical record. Information systems, information technology, information literacy, information management-information is all around us every day. Understanding how to evaluate the information available is critical to deciphering the true unbiased detail of the data. Although there is no control of the validity of data available on the Internet and the fact that there is an abundance of information, doesn’t necessarily mean the information on the subject is valid. Following criteria designed to evaluate information, will help an individual find and use quality information. Some criteria to use: is the source or authority reliable; is the data current; is it organized logically and easy to navigate; is it objective and free of bias; and is the data accurate and error-free. Developing a checklist and a form to assist with data collecting and decision making will serve as tools to enhance the evaluation of on-line material. In this age, information is plentiful. Understanding how to collect and process information is vitally important. One simply must be information literate.

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Internet Access: Changing Rural Nursing

January 5, 2010

Working in a small rural hospital you get used to doing without and making do with what you have. Money is always an issue, and the nursing staff longingly looks at more modern equipment, better forms, and electronic medical records.

While we may be small, we are still held to the same standards of nursing that any nurse is held to. We still need to do patient assessments, carry out doctors orders, and give good, solid patient care. The area that becomes problematic is in the education and discharge instructions that must be given to patients. Without the money to buy programs it has long been a struggle to develop adequate information that can be disseminated to the patient. It is now possible to go on line and take advantage of many free programs that offer patient education materials and discharge instructions.

Our hospital has been able to pick a site that the nurses and providers felt met our needs, and we can go online and print off any education and discharge instructions that will meet each patients needs. We are now able to give disease specific, up to date, instructions. Our patients are now very informed on their disease process, and we passed our Critical Access Hospital survey tag dealing with education and discharge planning.

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Patient Education, Computers, Internet; comment

December 28, 2009

I agree that the medical knowledge is much easier for everyone to obtain. It has made it much easier to provide patient education to our patients in the occupational healthcare setting. We simply go to a program called Dynamed and can quickly obtain the information we need, print the patient education flyers, and even obtain continuing education credit for completing the entire reading on the topic. This has made it very easy to provide concise, complete, and up to date information on a variety of topics. I remember 20 years ago in the ER, we had a "card" file on about 20 diagnoses that we gave to patients for information on their diagnosis. It was very generic and non-specific compared to today’s Internet information.

Original Post
May 27, 2009
Title: Patient Education, Computers, Internet
The Internet has made access to medical knowledge much easier for everyone to obtain. At one time the information was only available through books, available at the Dr.’s office, hospital library, or medical library. The information is now available to patients as well as anyone who wants to find more information on a medical subject.
At the click of the mouse, a nurse can find out if 2 medications are compatible in IV form. Before she would have to look it up in an IV handbook, if one was available, or call the pharmacy.
I find that some patients are more informed about their own health, and can participate in their own healthcare, especially when multiple disciplines are concerned. Patients can also look on the Internet and see if there are any natural treatments to assist in their care and then discuss them with their physician. When you pick up an RX, there is printed information about the drug with it.
The Internet has made it possible for many to obtain medical information to either help them as a patient or health care provider.

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Medical information and the Internet, comment

December 14, 2009

I totally agree with you regarding the medical information on the Internet. Have you ever tried to research a medical issue and found so many different sources that even as a medical professional, you don’t know what to trust? I have become very leery of the purpose of each site that I visit for information. Sometimes, they are just trying to sell something like vitamins. I have become aware of the need to check what audience that they are serving in order to determine the validity of their information. Another important issue to check when looking for information is the date that the information was provided since it is very important that medical information is up to date and not stagnant. I always suggest to my patients that they run the information about their diseases past their doctor to determine if it is appropriate to their own personal medical issues.

Original Post
September 25, 2009
Title: Medical information and the Internet
It is becoming increasingly difficult to gauge the reliability of health information on the web. Just until recently, it was extremely difficult for many people to search for healthcare information, but advances in technology, such as the Internet, are making it more accessible. Patient centered medical information on the Internet could provide healthcare professionals with the opportunity to learn more about patients’ and relatives’ concerns and to refer them to such reliable sources of information when and where appropriate. However, little has been done to assess, control, and assure the quality of this medical information that has flooded the web. Difficulty in judging the validity of this influx of medical information thus poses a problem for people using the Internet. The Internet can be a good source of information on common health problems, but advice obtained through the web should not be a substitute for routine care by a family doctor or other medical professional.

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Patient Interaction with their Disease

August 20, 2009

Wouldn’t it be cool if patients who are admitted to the hospital for a chronic illness could be connected with an online program that teaches them about their disease? Maybe the patient could check out a laptop for a few hours and then there could be information given to them about their disease. Medications and the important information that goes along with them could be reviewed (this could be tailored specifically to the medications the patient is taking/will be sent home with). Also a little pathophysiology lesson could be given in an interactive exercise that reviewed anatomy and then changes at the cellular level due to the chronic disease. The program could then go into warning signs of an exacerbation of the disease and when to contact their health care provider or call 911. At the end it could talk about how the patient can work to control their illness at home. The program could include print offs of the medications and disease information. If the patient had questions they could take notes and ask their health care provider before their discharge. I think it is so important for a patient to feel that they can have control over their chronic illness. I think that if patients were better educated about their disease processes that hospital admissions/exacerbations would decrease. I firmly believe in educating patients about their illnesses and believe that a user-friendly computer program would greatly benefit patients.

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July 31, 2009

As a nurse, learning never stops. You have to maintain your license, obtain CE credits, certifications, and facility education requirements. Hospitals have tried several ways to have all nurses compliant. By providing lunch and learns, take home packets, mandatory staff meetings, or coming in on your day off to complete all your requirements. Many nurses get frustrated with this, they don’t want to stay after there shift, or come in on there day off, or read a packet of information. Many hospitals are now using E-learning, which is a form of online education. Each healthcare worker is assigned there list of courses to complete with a due date. Managers are able to track who is compliant. CE courses are even provided. Nurses can access this at work or at home. The company I work for even provides e-learning courses free of charge for hospital nurses. For example if JACHO arrives and ask you to prove if there staff is competent with a product. As the manager you can pull up there e-learning records and show proof of completion. Making our busy nurse lives easier!!

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